• Article
  • October 27, 2017

What Different Generations Want From a Health Care Experience

Generations of parents and patients expect different things from their experience in a children's health care setting. Is your hospital keeping up?

By Megan McDonnell Busenbark

Fall 2017 cover

It was August 19, 2015, when Jessica Miller came face-to-face with her "new normal." That's when her daughter, Maggie, was diagnosed with Type 1 diabetes. And so began the relationship between the Miller family and Children's Hospital of Wisconsin.

It was here, Miller says, where the care team minimized the "fear factor" for Maggie. Where they shared just the right amount of information to help a 6-year-old understand what was happening. Where they provided a clear care plan and offered technology tools to help make it happen. All this has given Miller and her family the kind of overall experience they want when getting care for Maggie.

"The first thing that comes to mind is Maggie's experience at Children's Hospital of Wisconsin as the patient," says Miller. "They treat her like a human. They talk to her—they don't talk above her. They involve her in her care. The biggest part of the experience is that human connection—although technology is important too."

It's all about the experience

Fall 2017 cover

PARENTS TODAY: Millennials

Also known as Gen Y

  • Age right now: About 22 to 37
  • Remember going from cellphone to smartphone
  • Conduct online research before interacting with health care team
  • Want technology and human touch
  • Expect efficiency, short wait times
  • Want “medical passport” so all records are in one portable place

"Experience" is paramount to Miller's generation—not only in the children's hospital, but in life. At 37, Miller is a millennial. Also known as Generation Y, this generation came of age with technology. Demographers and researchers typically say this generation was born between the early 1980s and the mid-1990s, and these are the parents in the halls of the nation's children's hospitals today. When they bring their children into the health care setting, they expect the same kind of experiences they get from their everyday lives, which presents new challenges—and opportunities—for children's hospitals.

"Parents come into the hospital expecting to have more of a consumer relationship, not a health care relationship," says Jason Dorsey, co-founder and millennial and Gen Z researcher at The Center for Generational Kinetics, a research and consulting firm focused on these generations, and author of Y-Size your Business: How Gen Y Employees Can Save You Money and Grow Your Business.

A whole new generation of patients and parents

A snapshot of today's children's hospital population would reveal a largely millennial parent base with mostly Generation Z patients. Keeping in mind that Gen Z will be the next wave of parents, children's hospitals need to get to know both of these populations better to serve their changing needs and meet their modern-day expectations.

"It's clear the young parents and kids now put a very high value on convenience," says Bob Connors, M.D., president of Helen DeVos Children's Hospital in Grand Rapids, Michigan. "Of course, they value the traditional equation, which is high quality and low cost. But there is an availability, an accessibility and a convenience aspect—almost an on-demand expectation of these younger people—that is substantially different than it was 10 years ago. So hospitals have to change the way they think about things to respond to that."

Two key areas hospitals should think about differently, Connors says: education and communication. "We're seeing changes in the way young parents and their kids process information," says Connors, who has been a practicing pediatric surgeon for more than 20 years.

"They learn differently. They are reliant on digital tools; they are online a lot. Their attention span is short. They love gaming. This is going to drive pediatric providers in terms of education, helping people understand what's going on with their kids while they are facing very difficult diseases or injuries." Connors says children's hospitals will have to be attentive to that education, as these parents and kids are learning in somewhat different ways.

They are also communicating in different ways than parents and patients of the not-so-distant-past. Even though health care professionals realize their consumers make up the texting generation, the extent to which millennials (parents and possibly older patients) rely on this mode of communication is staggering. "This is a generation that may talk 10 minutes on the phone a month and send 5,000 text messages," says Dorsey, who is a also a millennial.

What about Gen Z?

3 ways to make a connection

Hospital leaders share their tips for making the most of every interaction with families.

  • Just ask. "We can make educated guesses about what young families and patients want, but they are the only ones who really know. And they will tell you what they need. So ask them what they want." —Bob Connors
  • Look beyond the chart. "Everyone wants their child to be viewed as one of a kind. And the experience they expect to have in the hospital and clinic is that you're looking beyond the medical chart—you are seeing the whole child and the family as human beings, not just a medical case." —Scott Perryman
  • Sweat the small stuff. "We have a saying around here that 'Little is big.' Every little encounter you have is important in how that family interprets the experience." —Peggy Troy

This group is today's patients and tomorrow's parents. The oldest members of this emerging generation are 20 years old right now, and they represent the next generation of parents in children's hospitals. Members of this demographic were born after the millennials, but their mindset is a bit different from that of their generational predecessors. And they will up the technology ante for children's hospitals because the tech way of life is the only one they know.

"Gen Z doesn't remember a time before they could do everything on a mobile device," says Dorsey. "There is no history before watching TV on your phone. It doesn't exist." This is an important distinction, he says, because a person's natural or native relationship with that technology frequently determines their expectations in health care.

This is something that Scott Perryman, MBA, knows well. As senior vice president and administrator of Loma Linda University Children's Hospital in California, Perryman and his team conducted research that revealed the importance parents and families place on the ability to conduct business as usual while they're inside the children's hospital walls—even if they're only there one day.

Parents say they can't function as a family if they can't access the technology they use to manage their lives. "This is not a nice-to-have," says Perryman. "It's a necessity for them. If they don't have access to the technology they need to manage their life within the hospital, they feel they can't stay connected to manage their life outside the hospital."

Everyday life

This "everyday life" factor extends beyond just technology. To meet the expectations of consumers today—and tomorrow—children's hospitals should work to provide smoother sailing in other aspects of patient and family lives, Perryman says. For example, Loma Linda University Children's Hospital is building a new tower set to open in 2020. Here, patient rooms will be private and roomy, and the tower will have more reflection and respite space to offer a better consumer experience. But the hospital is going further than that.

"We are upgrading our systems to provide more of a retail-like, hotel-like experience," Perryman says. This includes things like enhanced patient communications, kitchen service and technology like MyChart for increased on-demand access to information and updates. And while that at-your-fingertips information is high on the list of family priorities, real-time availability of data — including test results — can also pose a problem for care teams and families.

"It's a tricky balance as a provider to think that through, because on the one hand, giving patients access to medical information and their health records is a good thing," says Amy Starmer, M.D., M.P.H., pediatrician; director of primary care quality improvement; associate medical director, Department of Medicine at Boston Children's Hospital and assistant professor of pediatrics at Harvard Medical School.

"So we want to promote that. But at the same time, there's a reason it takes four years to get through medical school—to be able to interpret and understand which tests are needed, to determine the reliability of sources and to avoid misinformation that can lead to more parent and patient anxiety than is necessary. It's a challenge."

The key is to talk one-on-one with families about diagnoses or test results that are more complicated and require context before making them available on a technology platform. According to Peggy Troy, RN, M.S.N., president and CEO of Children's Hospital of Wisconsin, the overall children's hospital experience should start long before the patient and family walk in the front door.

"The experience begins from the minute you decide you need the care," Troy says. "And it includes things like what the traffic is like coming into the hospital, and how to navigate the campus, how friendly the valet service was, and how the hospital's text messaging system works before, during and after care. We need to think about the patient and family experience before they come in the door and after they leave."

Reliant on crowdsourcing

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PARENTS IN FIVE YEARS: Generation Z

Also known as iGen, Centennials, Founders

  • Age right now: Oldest members are 20
  • Have only lived in times when everything can be done on a mobile device
  • Face-to-face conversation will be less “normal”
  • Telehealth will be “normal” expectation; will not want a physical visit
  • Will rely more on recommendations and reviews for health care choices than millennials
  • Focus more on wellness than response to illness

Compiled with insights from Jason Dorsey, The Center for Generational Kinetics

The current and future patient and family also rely heavily on peer recommendations, which influence where, and from whom, they decide to seek care for their children. "We found that people are increasingly willing to listen to their peer groups about where to go for care," says Perryman.

"Sometimes even placing these opinions above the recommendations of their physician or the requirements of their insurance plan or company. Economics are a huge factor here, and people are more price sensitive than in the past." And today's parents are highly likely to look at star ratings when researching caregivers, with a close eye on the overall experience factor.

"Millennials rely on crowdsourced feedback, and that's one way they can get a first view of how a physician is ranked by families," says Troy. "How families rank you has a lot to do with how you treat them. A surgeon can do the best job possible in the operating room, but this is about that human interaction and how people feel about their experience."

Dorsey says this is a generation that lives on recommendations. "Just think about all the analytics behind the scenes that recommend what movies we see, what we eat or drink and where we should we go on a trip," he says. "That is going to become extremely normal over the next five years."

Something else care teams at children's hospitals should be on the lookout for over the next five years: the effect of the communication style that Gen Z is growing up with. Because this generation does not talk face-to-face, or even by phone, as much as previous generations, having one-on-one conversations with the younger generations about difficult diagnoses for their children may be tougher than ever.

The key is to recognize these parents are still parents. "They still have concerns about their kids," Dorsey says. "The difference is how you communicate and connect with them. It's how you steer some of the behaviors so they become compliant if it's a health issue or proactive if it's a wellness issue."

Forward progress

Miller has gratitude for the quality care and the overall experience she has found at Children's Hospital of Wisconsin. True to her millennial profile, she also relies heavily on technology when it comes to managing Maggie's care. She uses an app to monitor Maggie's blood sugar checks and insulin doses while she is in school, and Miller taps MyChart for information tracking and communicating with Maggie's care team at the hospital.

She says just in the two years Maggie has been treated there, Children's Hospital of Wisconsin made significant technological and convenience advancements. "Sometimes, when you go into a health care setting, you feel like you've stepped back a few years because they're not quite caught up to everything," says Miller. "But at Children's Hospital of Wisconsin, they are meeting families' needs."

The one constant

Despite new demands and expectations from patients and families, one thing is expected to stay the same as it was 100 years ago. "Having the best and safest care transcends generations; that is the one thing that will stay constant," says Troy. "And what is it going to be like five years from now? As children's hospitals, we know the most important thing people want is the best and safest care for their kids. What cascades from there is convenience, access, transparent pricing and the ability to connect with us in the moment when they need answers to questions."

Megan McDonnell Busenbark is a writer and founder and principal of Encore Communications LLC in New Fairfield, Connecticut. Send questions or comments to magazine@childrenshospitals.org.